The application is a pilot for a post-hospital home telemonitoring intervention to help people with lung cancer (CA) recognize changes in their condition and contact a clinician before emergent care is needed. WV lung CA illness and death rates exceed US averages. Limited knowledge and access to care have contributed to significant health disparities for WV lung CA patients, especially in rural areas. There is a critical need for low cost, high quality interventions to assist patients during the first two weeks following hospital discharge before they have scheduled follow-up clinician visits. Phone-transmitted telemonitor data will be used to alert nurses to explain changes in signs/symptoms and coach patients on when and how to contact a clinician. Telemonitors will provide early evidence of disease-related changes which can then be recognized by patients and relayed to their clinician before they exacerbate. To date, there have been no studies of telemonitor data used for education of adults with lung CA. Measures of effectiveness will be patient contacts to nurses/physicians, changes in treatment, use and cost of health care resources for 2 months following hospital discharge, as well as patient quality of life (QOL), and functional status. Study specific aims are: (1) Describe changes in telemonitored physiological measurements and subjective symptoms over 14-days following discharge in the telemonitor group;(2) Examine the differences in functional status, QOL, and patient/family satisfaction with and without home telemonitor-based education for self-management;and (3) Analyze differences in nurse/physician contact, treatment changes, and healthcare resource utilization with and without home telemonitor surveillance education for self-management. This study is important because improved knowledgeable patient self-management could impact long term outcomes. Patient direct contacts to clinicians for treatment and self-management would be less costly compared to emergency care or rehospitalization. Successful completion of the study would also help to fill the gap in knowledge about changes in lung CA patients'vital signs and symptoms between hospital discharge and the usual 2 week post-hospital visit. Consistent with the missions of NIH and NCI to build a knowledge base to alleviate the burdens of illness and disability and provide continuing care of cancer patients, our R15 grant application supports patient self-management based on signs/ symptom identification for appropriate clinician contact before problems exacerbate, improving QOL for adults with lung CA, and examining the satisfaction of patients and families with limited (14 day) telemonitor use. Nursing knowledge will be used to interpret telemonitor data and educate cancer patients at home after hospitalization. Short term remote telemonitoring-based patient education offers a promising option to develop patient self-management knowledge and skills. PUBLIC HEALTH RELEVANCE: High costs of care for patients with lung cancer have been related to frequent hospitalizations and emergency care visits. There is a critical need to identify interventions to help people with lung cancer recognize changes in their condition and contact a clinician before emergent care is needed. The proposed study uses a self-management model to test the use of home telemonitors as risk indicators after discharge in a sample of Appalachian adults hospitalized with lung cancer and comorbidities. Phone-transmitted telemonitor information will assist nurses to explain changes in signs/symptoms and coach patients on when and how to contact a clinician. Addressing health disparities for adults with lung cancer by cost-effectively reducing risks for rehospitalization/emergent care and improving life quality is critical to "Healthy People 2010".